This Saturday, May 12, is National Fibromyalgia Awareness Day, so it’s a perfect time to talk about fibromyalgia as it relates to opiate use. Over the past few years we’ve seen an increased number of fibromyalgia patients that have started receiving prescriptions for painkillers to address their chronic pain symptoms. As a Registered Addiction Specialist, this is extremely concerning to me especially at a time when we are also seeing prescription painkiller use exploding nationwide.

Fibromyalgia is a musculoskeletal condition that is marked by widespread aching and pain in the muscles and joints. Fibromyalgia affects more than 12 million Americans, and women are 10 times more likely to suffer symptoms than men. Some symptoms of fibromyalgia can include:

While the causes of fibromyalgia are unknown, many researchers believe the condition can occur from hormone imbalances that affect the central nervous system, as well as stress, illness or certain types of trauma.

Fibromyalgia can be very challenging to treat, and although there is limited evidence showing that opioids are an effective form of treatment, it seems these prescription painkillers are prescribed frequently for fibromyalgia patients. According to a study published in the American Journal of Medicine, approximately one-third of the patients who participated had been prescribed opioids for their condition; and two-thirds of them had received “strong opioids.”

Fibromyalgia can be a debilitating condition that affects the quality of a patient’s everyday life, but there are several alternative therapies that can be helpful in achieving relief from fibromyalgia. Unconventional treatments like acupuncture, electro acupuncture, biofeedback, chiropractic care, massage therapy, and even meditation have been shown to help alleviate pain for some patients. While alternative therapies may be helpful, it is always recommended that patients consult their doctor before starting any treatment program.

National Fibromyalgia Awareness Day is sponsored by the National Fibromyalgia & Chronic Pain Association (NFMCPA). On May 12 and throughout the month of May, the NFMCPA will work to raise awareness for the condition by offering activities and other opportunities for local communities to participate. For a list of local resources and local events, please visit the NFMCPA at fmcpaware.org.

Patients who are prescribed long-term prescription painkiller treatment programs should be cautious of opioid-induced hyperalgesia. Opioid-induced hyperalgesia is a condition where the increased use of opiates, like Oxycontin and hydrocodone, heightens one's sensitivity to discomfort and reduces their tolerance for pain. Essentially, people will increase the amount of painkillers they are taking as their discomfort continues to escalate, but the added medication can actually make their pain worse.
Opioid-induced hyperalgesia is often times mistaken for a growing tolerance to pain medication, which is why dosages are increased. Unfortunately, increasing the dosage is not only ineffective, but can worsen the hyperalgesia and cause even more pain, creating a dangerous cycle. The most effective and safest way to remedy the condition is to decrease the dose or detox and eliminate the pain medication altogether. While it can be scary for a chronic pain patient to imagine no longer taking medication, we’ve actually seen patients suffering hyperalgesia realize they were pain-free once they relinquished their pills. It’s very important that hyperalgesia be differentiated from chronic pain so doctors are able to properly treat the problem and lessen pain, without causing or escalating physical dependence. Long-term opiate use can hinder or even stop the body's ability to produce natural endorphins, which is why many patients receive relief from pain once their bodies are able to recover this natural function.
If a patient is experiencing tolerance or opioid-induced hyperalgesia, the risk of dependency is very high. Increasing dosage, which many patients do without consulting their physicians, can increase dependency risk and can even lead to overdose or death.
At the Waismann Method Treatment center we take our patients to Domus Retreat after detoxifcation for a better evaluation on their pain level. We begin treatment with non narcotics and provide yoga, acupunture, massage and other forms on therapies that can help with prescription abstinance and pain control.

We’ve treated thousands of patients for dependency to painkillers over the past 13 years, and one of the concerns I hear most frequently is how quickly and unexpectedly our patients found themselves unable to stop taking the medication. Unfortunately, that physical dependnecy and craving leads people to feel unwarranted shame, and they’ll often put off seeking treatment for fear of telling their loved ones. It’s important for anyone battling a painkiller dependency to understand it’s not their fault and anyone prescribed medication is susceptible. Some important facts that people should know about painkiller dependency include:

o Dependency to prescription painkillers is often referred to as the fastest rising type of addiction in the country. It has even surpassed cocaine and marijuana in some communities.
o Two million Americans use prescription opiates every year, making the chance for dependency significant in our population.
o Many prescription painkiller dependencies start with a prescription for traumatic, acute, or chronic pain. It could be caused by a car accident, sports injury, migraines, arthritis, or a host of other pain sources. Physical dependency can begin after as little as two weeks, and many people experiencing pain are prescribed medication for at least that long.
o We speak with many patients who felt their doctors overprescribed opiate painkillers to them, and that they weren’t warned properly of the risks. Focused on eliminating pain, physicians can overlook the long-term consequences of dependency. Sufferers of dependency then became afraid to alert medical professionals for fear they would be taken off the drugs they’ve now become reliant on.
o In addition to pain from the initial injury, patients start to experience the painful discomfort of withdrawal. The pain has not eased, but intensified. We’ve seen patients whose pain jumped to level 8 or 9 after a year of painkiller use.
o Over time the body becomes tolerant of opiates so higher doses are needed in order to achieve the same effect. This can causes the dependency to worsen and spiral out of the control of the patient.
o Opiate dependency is a chemical imbalance that requires medical intervention. It stems from prolonged use of painkillers, and is not a personality flaw.

One of my goals has always been to erase the stigma associated with prescription drug dependency, and to help educate the public that opiate dependency is a medical condition that should be reversed in a hospital setting by trained physicians, combined with a customized aftercare program. We need to empower people with the information and resources they need to get help, and spread the word that there is assistance available.

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